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Impact of asthma medication and familial factors on the association between childhood asthma and attention-defict/hyperactivity disorder : a combined twin- and register-based study

机译:哮喘药物和家族因素对儿童哮喘与注意缺陷/多动障碍之间关联的影响:一项基于双胞胎和登记的联合研究

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摘要

BACKGROUND:Asthma and attention-deficit/hyperactivity disorder (ADHD) are prevalent in childhood and may cause functional impairment and stress in families. Previous research supports an association between asthma and ADHD in children, but several aspects of this relationship are unclear. OBJECTIVE:Our aim was to study whether the association between asthma and ADHD is restricted to either the inattentive or the hyperactive/impulsive symptoms of ADHD, to explore the impact of asthma severity and asthma medication and the contribution of shared genetic and environmental risk factors on the asthma-ADHD relationship.METHODS:Data on asthma, ADHD, zygosity and possible confounders were collected from parental questionnaires at 9 or 12 years on 20 072 twins through the Swedish Twin Register, linked to the Swedish Medical Birth Register, the National Patient Register and the Prescribed Drug Register. The association between asthma and ADHD, the impact of asthma severity and medication, was assessed by generalized estimating equations. Cross-twin-cross-trait correlations (CTCT) were estimated to explore the relative importance of genes and environment for the association.RESULTS:Asthmatic children had a higher risk of also having ADHD [odds ratio (OR) 1.53, 95% confidence interval (CI): 1.16-2.02]. The association was not restricted to either of the two dimensions of ADHD. The magnitude of the association increased with asthma severity (OR 2.84, 95% CI: 1.86-4.35) for ≥ 4 asthma attacks in the last 12 months and was not affected by asthma treatment. The CTCTs possibly indicate that the genetic component in overlap of the disorders is weak.CONCLUSIONS AND CLINICAL RELEVANCE:Childhood asthma, especially severe asthma, is associated with ADHD. Asthma medication seems not to increase the risk of ADHD. Clinicians should be aware of the potential of ADHD in asthma. Optimal asthma care needs to be integrated with effective evaluation and treatment of ADHD in children with co-existing disorders
机译:背景:哮喘和注意力缺乏/多动障碍(ADHD)在儿童期普遍存在,可能导致家庭功能障碍和压力。先前的研究支持儿童哮喘与多动症之间的关联,但这种关系的几个方面尚不清楚。目的:我们的目的是研究哮喘与ADHD之间的关系是否仅限于注意力不足或多动症的多动/冲动症状,以探讨哮喘严重程度和哮喘药物的影响以及共同的遗传和环境危险因素对哮喘的影响方法:哮喘,ADHD,合子性和可能的​​混杂因素的数据通过瑞典双胞胎登记表从瑞典问卷中收集,该问卷来自9或12岁的20 072对双胞胎,并与瑞典医疗出生登记表,国家患者登记表相关和处方药注册簿。哮喘和多动症之间的关联,哮喘严重程度和用药的影响,通过广义估计方程进行了评估。结果:哮喘儿童患ADHD的几率也更高[优势比(OR)为1.53,置信区间为95%],估计患病关联的基因和环境的相对重要性。 (CI):1.16-2.02]。该关联不限于ADHD的两个维度。在最近的12个月中,≥4次哮喘发作,关联的程度随哮喘严重程度的增加而增加(OR 2.84,95%CI:1.86-4.35),并且不受哮喘治疗的影响。 CTCTs可能表明该疾病重叠的遗传成分较弱。结论和临床意义:儿童哮喘,尤其是重度哮喘与多动症有关。哮喘药物似乎不会增加多动症的风险。临床医生应意识到多动症在哮喘中的潜力。合并哮喘患儿的最佳哮喘护理需要有效评估和治疗多动症

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